CDC and ADA Recommendations for
Dental Unit Water Quality
In 2012 a woman died after contracting Legionnaires' Disease from her dentist's office. This year more than 57 children were hospitalized following bacterial infections that were traced to contaminated dental waterlines. Although there are no strict requirements to testing and cleaning dental waterlines, there are plenty of useful recommendations to consider.
CDC Key Recommendations
1. Use water that meets EPA regulatory standards for drinking water (i.e., ≤ 500 CFU / mL of heterotrophic water bacteria) for routine dental treatment output water.
2. Consult with the dental unit manufacturer for appropriate methods and equipment to maintain the quality of dental water.
3. Follow recommendations for monitoring water quality provided by the manufacturer of the unit or waterline treatment product.
4. Use sterile saline or sterile water as a coolant / irrigant when performing surgical procedures..
ADA Recommendations
- Identify the source of water for your dental unit.
- Municipal water supply: This source may provide limited access to the waterline, but in such instances there are options for controlling water quality: 1) install a point-of-use filter between the dental instrument and the waterline tubing, 2) retrofit the dental unit so that the water is supplied by a self-contained water system for easy delivery of chemical treatments (contact the dental unit manufacturer about installing a self-contained water system), or 3) install a system that allows delivery of cleaning agents at the junction box.
- Self-contained water system: A reservoir (bottle) that attaches to the dental unit waterline, which isolates it from the municipal water supply. Water (tap, distilled, sterile etc.) must be added manually. The simple task of regularly adding cleaning agents to the bottle make this a convenient system.
- Municipal water supply: This source may provide limited access to the waterline, but in such instances there are options for controlling water quality: 1) install a point-of-use filter between the dental instrument and the waterline tubing, 2) retrofit the dental unit so that the water is supplied by a self-contained water system for easy delivery of chemical treatments (contact the dental unit manufacturer about installing a self-contained water system), or 3) install a system that allows delivery of cleaning agents at the junction box.
- Identify products that fit your needs and are compatible with your dental unit (contact the dental unit manufacturer). Some cleaning agents, like bleach, can corrode parts of the dental unit.
- Develop a schedule for waterline maintenance (based on manufacturer recommended treatment methods) and assign the duty to a particular person.
- Establish a protocol for monitoring the quality of dental unit water.